Prof. Peter Piot, the former head of UNAIDS and current Director of the London School of Hygiene and Tropical Medicine, paid a visit to Japan this fall, during which JCIE coordinated several of his meetings, including a breakfast meeting with nine members the Parliamentary Caucus on the Promotion of Human Security (chaired by Masahiko Komura) and a visit to a Tokyo community center, akta, that carries out AIDS prevention initiatives.

Piot was at the forefront of the discovery of the Ebola virus in 1976 and in the global struggle against HIV/AIDS that began in the 1980s. He was the first person to head UNAIDS after it was founded in 1995, and has continued to lead the fight against communicable disease since retiring from that post in 2008. Piot is considered to be one of the leading figures in convincing the international community to view AIDS not only as a medical issue but as an issue that affects the security and economic interests of nations as well, and has strengthened the global support for combatting this deadly disease.

During his meetings in Japan, the Ebola outbreak was in the headlines. He described how the current outbreak is very different from previous outbreaks because of what can be called a perfect storm: The three countries in West Africa where the virus is most widespread suffered from long civil wars, corrupt rule, and a lack of health systems, aggravated by a very slow response that took eight months from first detection to the declaration of a public health emergency. This latest outbreak of Ebola prompted a resolution from the UN Security Council—only the second time in history that it has addressed a public health emergency, the first being the HIV/AIDS pandemic. In an age of globalization, border control is difficult, so countries need to have medical and nursing personnel prepared to handle epidemics, but more importantly, to bring the outbreak in West Africa under control.

With regard to HIV, Prof. Piot noted that the virus used to be just as fatal as Ebola, but now the world has the means to fight the disease thanks to the concerted efforts of national governments and international organizations. The main actor in successfully decreasing the number of infections and deaths from HIV/AIDS is the Global Fund, the creation of which owes much to Japan and the Okinawa G8 Summit. It shows how one country can contribute to global affairs through a thoughtful initiative. But he stressed that the threat of AIDS is not over, and we need to have health systems and universal health care to tackle epidemics like AIDS, Ebola, and any other future outbreaks. He warned that allocating global health funding to Ebola at the expense of HIV/AIDS, tuberculosis, malaria, and mother and child health issues would only lead to more deaths and that assistance to fight Ebola should be allocated from humanitarian relief funds, not by decreasing funding for the global health agenda.

Piot also visited akta, an HIV/AIDS information center based in Shinjuku 2-chome, an area of Tokyo known as being home to a large LGBT community. Piot met with representatives from akta, from a support group for Japanese people who are HIV positive, and from other AIDS-related NPOs, as well as researchers in the field. Piot emphasized the importance of the community approach and how often that tends to get forgotten behind biomedical research and policies. He shared with those at the meeting that he is often disturbed to hear international organizations and professionals saying how the end is in sight for AIDS because it is not true, and he cited examples of increasing numbers of infections in London and elsewhere.